CHAPTER- 04 REPRODUCTIVE HEALTH According to WHO, reproductive health means total well-being in all aspects of reproduction i.e. physical, emotional, social and behavioral. Reproductive Health: Prole! a"d #trate$ie% •
To attain total reproductive health as social goal, action plans and programs at a national level are initiated at national level. These programs are called family planning initiated in 1!1.
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"mproved programs covering wider reproduction related areas are currently in operation under #$H %reproductive and child health care&.
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'roper information about reproductive organs, adolescence and related changes, safe and hygienic se(ual practice, )T* and A"*) would help people to lead a reproductively healthy life.
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A!"ioce"te%i% is A!"ioce"te%i% is a foetal se( determination test based on chromosomal pattern in amniotic fluid is surrounding the developing embryo.
+etter awareness about the se( related matters, increased number of medically assisted deliveries and better post-natal care leading to decreased maternal and infant mortality rate, increased number of couples with smaller families, better detection and cure of )T*s. Populatio" E&plo%io" a"d 'irth Co"trol "mproved uality of life of people, increased health facilities and better living condition had an e(plosive impact on e(plosion of population. #apid decline in death rate, # %maternal mortality rate& and "# %infant mortality rate& along with increase in population of reproductive age is the main for population e(plosion. )teps to overcome population e(plosion sing various contraceptive methods. o /ducating people about the demerits of large family. o o "ncreasing the marriageable age of female and male o 'roviding incentive to parents having 1or 0 children. Co"traceptive !ethod% !ethod% are used to prevent the unwanted pregnancy and modifying the menstrual cycle. An ideal contraceptive should be ser friendly /asily available /ffective #eversible o side effects o way interferes with se(ual desire and se(ual act. $ontraceptive methods could be divided into following categoriesa& atural or traditional methods b& +arrier methods c& "*s d& Oral contraceptive methods •
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e& "n2ectable f& "mplants g& )urgical methods. (atural !ethod% wor3s on the principle of avoiding chances of ovum and sperm meeting. "t includesPeriodic a%e"tee- the couples avoid coitus from day 14 to 15 of menstrual cycle. )ithdra*al or coitu% i"tercept% + male partner withdraws penis from vagina 2ust before e2aculation. Lactatio"al A!e"orrhea + absence of menstruation after parturition and intense mil3 feeding a"d no ovulation in this period. "n 'arrier !ethod%, ovum and sperms are prevented from physical meeting with help of barrier. This includesCo"do!%- used by male, barrier made of rubber or late( sheet used to cover penis or vagina and cervi( of female. "t also prevents from )T*s.
$ondom for male condom for female Diaphra$!%, cervical cap a"d vault% are barrier made of rubber that is inserted into the female reproductive tract during coitus. I"tra uteri"e Device%- inserted by doctor or trained nurse into the female uterus through vagina. "$*s may be non-medicated %lippes loop&, $u-T, 67-04 etc. "$*s increase the phagocytosis of sperm in uterus and copper reduce the motility and fertility capacity of sperms. "t is ideal for female that wants to delay pregnancy and spacing between two children. Oral Pill% are progesterone or progesterone-estrogen combination used by females in form of tablets. They inhibit ovulation and implantation as well as prevent entry of sperms into cervi(. Administration of progesterone or progesterone-estrogen combination within 50 hours of coitus is found to be very effective as emergency contraceptive. #ur$ical !ethod is used as terminal method of contraception in male and female to prevent any more pregnancy. 8asectomy Va%ecto! is the surgical method in male9 a small portion of vas deference is removed or tied through a small incision in scrotum to prevent release of sperms. Tuecto! is the surgical method in females in which small part of fallopian tube is removed surgically. Material downloaded from http://myCBSEguide.com and http://onlineteachers.co.in Portal for CBSE Notes, est Papers, Sample Papers, ips and ric!s
)election of suitable contraceptive methods and its use should be underta3en in consultation with ualified medical professionals. $ontraceptives are not regular reuirement for maintenance of reproductive health. They have played very significant role in chec3ing uncontrolled growth of population with some possible ill-effects li3e nausea, abdominal pain, brea3through bleeding, irregular menstrual bleeding and even breast cancer. .edical Ter!i"atio" o/ Pre$"a"c 8oluntary termination of pregnancy before full term is called T' %medical termination of pregnancy& or induced abortion. "t plays important role in decreasing population by aborting unwanted pregnancy. •
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"n "ndia, T' is legali:ed in 151 with some restriction to prevent its misuse such as indiscriminate and illegal female foeticides. T' is used to •
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7et rides of unwanted pregnancy due to unprotected intercourse or failure of contraceptives used during coitus or rapes. When pregnancy continuation could be harmful or even fetal to mother or foetus.
T's are considered relatively safe during first trimester or up to 10 months of pregnancy. )econd trimester T's are much more ris3ier. #e&uall Tra"%!itted Di%ea%e #TD%1 *iseases or infections which are transmitted through se(ual intercourse are collectively called se(ually transmitted disease or venereal disease %8*& or reproductive tract infecti on %#T"&. )ome common )T*s are 7onorrhea, syphilis, genital herpes, chlamydiasis, genital warts, trichomoniasis, hepatitis-+a and A"*). Hepatitis-+ and H"8 is also transmitted by sharing of in2ection needles, surgical instruments with infected person, transfusion of blood, or from infected mother to foetus. /(cept genital herpes, H"8 and hepatitis-+ are completely curable if detected earlier and treated properly. "nfections of )T*s can be prevented bya& Avoid se( with un3nown partners;multiple partners. b& Always use condoms during coitus. c& 7o to a ualified doctor in case of doubt for early detection and get complete treatment if diagnosed. I"/ertilit The couples which are unable to reproduce children inspite of unprotected se(ual cohabitation are called infertile. "nfertility may be due to physical, congenital, diseases, drugs, immunological or even physiological. •
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"nfertile couples can be assisted to have children through certain special techniues commonly called a%%i%ted reproductive tech"olo$ie% ART1. Which includesMaterial downloaded from http://myCBSEguide.com and http://onlineteachers.co.in Portal for CBSE Notes, est Papers, Sample Papers, ips and ric!s
I" vitro /ertili%atio" IV21-fertilisation outside the body followed by embryo transfer, which is commonly called test tube baby program. The ovum from wife;donor and sperms from husband; donor are collected and induced to fertili:e in laboratory conditions. The :ygote or early embryo %< blastomeres& could be transferred into fallopian tube called 3I2T %:ygote infra fallopian transfer& and embryo with more than < blastomeres IUT %intra uterine transfer& into the uterus to complete the further development. I2T $a!ete i"tra /allopia" tra"%/er1 +transfer of gametes collected from a donor into fallopian tube of another female who do not produce ovum. I"tra ctopla%!ic %per! i"5ectio" IC#I1- speciali:ed procedure to form an embryo in laboratory in which sperm is directly in2ected into ovum. Arti/icial i"%e!i"atio"- infertility cases in which male partner is unable to produce healthy sperms are treated by this techniue in which semen collected from donor is artificially introduced into vagina or into uterus, "" % intra uterine insemination& of the female. All these techniues reuire e(tremely high precision handling by speciali:ed professional and e(pensive instruments. There for their benefits are limited to certain countries and people. /motional, religious and social factors also prevent the adaptation of these methods.
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